With Covid infections soaring, new lockdowns in the EU and UK

Europe is in the midst of a second wave of Covid-19 infections—one that is much worse, in terms of numbers, than the first wave that began in late February and early March and peaked, after a number of states introduced lockdowns and various restrictions on activity, in late March and early April. Those early lockdowns and restrictions were effective in reversing the rapid acceleration in the number of infections, as was reflected in reductions in most of the states in the cumulative number of infections over the previous 14 days per 100,000—the measure the EU’s  European Centre for Disease Prevention and Control (ECDC) uses to control for population differences in comparing the extent of infection across the European states.  That number dropped from peaks of 168 in Spain, 141 in Belgium, 94 in Italy, 69 in France, 67 in Germany, and 64 in the Netherlands to less than 10 by the end of June and early July.

But the lockdowns and restrictions resulted in significant economic contractions and anxious governments, mindful of the economic costs, relaxed and, in most cases, ended the lockdowns and restrictions as the daily numbers of new infections dropped. And as complacency set in over the summer months—perhaps best exemplified by the huge street party in Prague in June to celebrate the country’s “victory” over Covid—the virus began spreading again and the number of infections—and in their wake the numbers of hospitalizations and deaths—quickly increased and soon surpassed those registered at the peak of the first wave. The day-to-day acceleration hasn’t been as rapid as the acceleration that occurred last March but the steady increase, continuing as it has for four months, has resulted in far greater numbers of Covid-19 infections in all of the countries than occurred even at the peak of the first wave. Thus, as of today, the cumulative number of cases over the previous 14 days per 100,000 has reached 577 in Spain compared with a peak of 168 in the first wave, 1669 in Belgium compared with a peak of 141 in the first wave, 539 in Italy compared with a peak of 94 in the first wave, 854 in France compared with a peak of 69 in the first wave, 237 in Germany compared with a peak of 67 in the first wave, and 760 in the Netherlands compared with a peak of 64 in the first wave. Notable among other states are the Czech Republic, where the 14-day cumulative number of infections per 100,000 as of today is 1,587, second only to Belgium, and Luxembourg, where the number is 1,367. In the UK, the 14-day cumulative number of infections as of today is 467, compared with 77 at the country’s first-wave peak in early May. For comparison, the 14-day cumulative number of infections per 100,000 in the U.S., which has averaged more than 85,000 infections a day over the past week, is 337 as of today—which conveys just how large the daily rate of infection is in Europe.

With many European states now facing much larger daily rates of new Covid infections, the intensive care units in hospitals in several states rapidly filling up and, in some cases, running out of space, and the number of Covid-related deaths increasing sharply in Belgium, France, Italy, the UK and other states, many governments have realized they have no choice but to move to another round of lockdowns and tough restrictions on activity, however costly that may be in economic terms. One of the first to do so was the Netherlands which, while currently having a 14-day cumulative number of infections per 100,000 of 760 that is well below the levels of infection in neighboring Belgium and Luxembourg, nevertheless has daily rate of infection that is substantially higher than the rates of infection in Italy, Spain and the UK. On October 13, Prime Minister Mark Rutte announced the Dutch government had decided on a series of measures as part of a new “partial lockdown” that took effect the next day. Under the new measures, no more than three persons a day are allowed to visit a home, no more than 30 people can be seated at indoor events, and no more than four people from mixed households can attend outdoor gatherings. All bars and restaurants are closed except for takeaway service, all retail stores except supermarkets and gas stations are closed by 8 p.m., sales and public consumption of alcohol are prohibited between 8 p.m. and 7 a.m., and face masks must be worn in public indoor spaces and on public transportation by all those over the age of 12. People are expected to work at home unless it is impossible, given the nature of their work, for them to do so, they are expected to travel within the country as little as possible, and those traveling are expected to follow the advice of the government in regard to travel warnings.

Although the daily rate of Covid infection, as measured by the ECDC, is somewhat lower in Ireland—as of today 220—than in a number of neighboring states, including the UK, on October 19 the Irish government announced it had decided to move to the highest of five levels of restrictions in its “plan for living with Covid-19,” adopted in September. In a televised address, Taoiseach Micheál Martin said that, although the government had introduced what he described as “Europe’s strictest regime” with the plan’s level-four restrictions, they had not significantly reduced the number of Covid infections. Under the level-five restrictions, which are broadly similar to last spring’s national lockdown and took effect on October 21, non-essential businesses have been closed, bars and restaurants are allowed to offer only takeout services, residents who can work at home are expected to do so, and they were urged to leave their homes only if they must in order to work, obtain essential services, or exercise. Gyms, pools, and other exercise facilities, already closed under level four, remain closed, citizens are not to travel, and they are limited to outdoor exercise only within five kilometers of their home. The level-five restrictions will remain in effect until at least December 1.

On October 22, the Czech government, which as noted above presides over the second-highest daily rate of Covid infection in the EU, announced a second national lockdown. In March, the  government introduced tough restrictions, including a requirement that face masks be worn in public, in order to limit the spread of the Covid virus. Those measures slowed the rate of increase in infections and in April the Czech Republic was, with Austria, the first EU member state to ease the first-wave restrictions. It subsequently removed all of the restrictions and, in what turned out to be a deadly “super-spreader” event, in June thousands of Czechs gathered in Prague to celebrate the country’s “victory” over Covid. That event, and the widespread view that the country had “defeated” Covid, contributed in no small measure to the rapid acceleration in infections, hospitalizations and deaths that occurred in the summer and fall, as a result of which the country now has the second-highest rate of Covid infection in the EU.

With its health system understaffed and unable to deal with the surge in hospitalizations, the Czech government declared a 30-day state of emergency on October 5 and on October 22, Prime Minister Andrej Babis, who had promised there would never be another national lockdown like the one imposed last spring, announced a second national lockdown, saying, “We have no time to wait. The surge is enormous.” Apologizing for the impact on people’s lives, he said, “I apologize even for the fact that I ruled out this option in the past because I was not able to imagine it might happen. Unfortunately, it has happened and now, above all, we have to protect the lives of our citizens.” Restaurants, bars, and clubs were closed as were many stores, shopping malls, and hotels. A curfew of 9 p.m. was established and shops were obliged to close at 8 p.m. Public gatherings were limited to six persons, travel was limited, and face masks were required in indoor public spaces and on public transportation, and schools moved to remote learning. Babis said if the measures hadn’t been taken, “our health system would collapse between November 7-11.” The restrictions will remain in place until at least the end of the state of emergency, which on Friday was extended from yesterday to November 20.

The daily rate of Covid infections began to increase dramatically in Spain in early July, well before it began to increase again in France, Italy, the UK and other countries in Europe, and by early October Madrid in particular was experiencing a dramatic acceleration in the daily rate of infection. On October 2, the government directed the region to ban all non-essential travel in and out of the capital and nine other cities in the region. The region, controlled by the opposition, objected, refused to implement the order, and challenged it in court, and on October 8 the court threw out the order. The next day the health minister, after noting that the Madrid regional government was “not doing anything,” that transmission levels were “very high,” and that hospitals were “at the risk of being overwhelmed,” announced that the government had declared a state of emergency in the Madrid region for two weeks and had restored the measures thrown out by the court. People in the region were prohibited from leaving their cities or neighborhoods except to go to work or school or for medical reasons; restaurants, bars, shops, theaters and hotels were limited to 50 percent of their capacity and would have to close at 10 p.m. or, in the case of restaurants and bars, 11 p.m.; and gatherings were limited to six people.

As the rate of infection continued to increase in the Madrid region and other metropolitan areas, and Spain became the first European state in which more than a million people had been infected, on October 25 Prime Minister Pedro Sánchez announced a national state of emergency for six months, until May 9, 2021. Under the national state of emergency, the regional governments were empowered to enact partial or full lockdowns, including limits on the hours and capacity of restaurants, bars, cinemas, theaters and museums, limit travel into and out of the region for up to two weeks, order curfews of 10 or 11 p.m. to 6 or 7 a.m. except for those who have to go out for work, medical reasons, or caring for the young and the elderly, and limit public and private gatherings to six people. “We have to protect our economic and work activity and preserve, as far as we can, the rhythms of our lives…No one, not the government of Spain nor its regional governments, wants to impose a single restriction that isn’t necessary to flatten the curve and protect public health….the more we stay at home and the fewer contacts we have, the more protected we’ll be, and the more we’ll be able to protect our loved ones and the health of everyone.” The parliament approved the state of emergency last Thursday.

Also on October 25, with the daily rate of Covid infections accelerating rapidly and reaching record levels, Italian Prime Minister Giuseppe Conte announced a state of emergency that took effect the next day and will remain in effect until the end of January 2021. Under the state of emergency, bars and restaurants are required to close at 6 p.m., all gyms, pools and movie theaters are closed, all secondary schools are online, travel is restricted, people are encouraged to remain at home unless they have to leave for work, medical reasons, or exercise, and face masks are required in indoor public spaces and outdoors between 6 p.m. and 6 a.m. On Monday, Conte announced additional restrictions that took effect today, including the closure of shopping malls on weekends, limits on travel to and from the most heavily-infected regions and reduction of seating on public transportation by 50 percent. But he also noted the restrictions would vary across the regions depending on the severity of Covid and emphasize that the government was not instituting a national lockdown.

Last Wednesday, with the number of Covid infections increasing and the number of hospitalizations doubling every ten days, and 1,500 patients in intensive care units, German Chancellor Angela Merkel and the heads of the 16 state governments, meeting in a videoconference, agreed on a partial lockdown to slow the rapid increase in the number of Covid infections and hospitalizations. The month-long lockdown began Monday and will continue until December 2. All bars, clubs, gyms, and theaters are closed, restaurants are limited to takeout and delivery service, fans are not allowed to attend football matches or other sporting events, most public events are prohibited and gatherings are limited to no more than ten people. Announcing the partial lockdown, Merkel said, “Within weeks we will reach the limits of our health system. We have to act, and act now, to prevent an acute national health emergency.”  She and the state leaders will meet again next week to assess the lockdown and, if necessary, take additional measures.

On the same day in France, with more than a million persons infected and 2,000 new patients being hospitalized every day, President Emmanuel Macron announced in a televised address a national lockdown that began at midnight last Thursday and will run at least to December. Saying “we are submerged by the acceleration of the crisis,” he said that while “the economy must not stop or collapse,” all bars, restaurants, and non-essential businesses would be closed, no public or private gatherings would be allowed, travel would be restricted, and non-EU travelers would not be allowed to enter the country.

On Friday, Belgium, which has the highest rate of Covid infection in the EU – so high that hospitals in some areas such as Liège have had to rely on staff who have themselves tested positive for the virus – followed suit. In a televised address, Prime Minister Alexander De Croo (whose predecessor until October 1, Sophie Wilmès, the Deputy Prime Minister and Foreign Minister, is currently hospitalized with Covid and spent six days in an intensive care unit) announced a series of measures to reverse the accelerating rate of infection and, hopefully, reduce the pressure on the health system. As of Friday, all non-essential businesses are closed, all who can work at home are required to do so, sales in supermarkets are limited to essential items, only one visitor at a time is allowed in a home, and gatherings in public places are limited to four people. The midnight curfew, instituted earlier, continues and all bars and restaurants remain closed. Addressing the country, De Croo said, “We are going towards a reinforced confinement with only one goal: avoiding that health-care services collapse….These really are the last-chance measures and it is up to all of us to make sure that these measures produce a result.”

Jens Spahn, Germany’s health minister, who has recovered from a bout with the Covid-19 virus, has offered space in German hospitals’ ICUs as long as it is available to neighboring countries in which all of the ICUs are filled. The first Dutch patient was transferred by helicopter to a German hospital on October 23, last Thursday the first patients from Belgium were transferred to German hospitals, and the government is currently making arrangements to transfer critically-ill patients from Czech hospitals that have no more ICU space to German hospitals as well.

On Saturday, Austrian Chancellor Sebastian Kurz, concerned about the “massive acceleration…almost explosive rise” in Covid infections – a doubling over the past week and increasing hospitalizations – and persuaded that the government’s regionally-differentiated “traffic light” system was not working well, announced a partial lockdown that began yesterday and will continue until December. Restaurants, cafes, and bars are closed except for takeaway service, hotels are closed to tourists, and gyms, cultural venues, theaters are closed, and sporting events cancelled. There is an 8 p.m. curfew except for persons going to work or going out to exercise, those who can work at home have been advised and urged to do so, visits with others are limited to members of two households, and high schools and universities will rely entirely on distance learning.

Also on Saturday, after the number of infections passed the one million mark, hospitalizations had significantly exceeded what scientific advisors a few weeks ago had described as the “worst-case scenario,” and the likelihood, given the high and increasing numbers of infections and hospitalizations, that the number of deaths in the next weeks and months would greatly exceed the number in the first wave last spring, British Prime Minister Boris Johnson announced in a televised address Saturday evening that a new month-long national lockdown will start tomorrow and last until at least December 2. Speaking after Dr. Chris Whitty, the Chief Medical Adviser, and Sir Patrick Vallance, the Chief Scientific adviser, presented data on the current extent and likely trajectory of Covid infections and Covid-related hospitalizations and deaths, Johnson said, “no responsible PM can ignore the message of those figures.” Continuing, he said, “No one wants to be imposing these kinds of measures anywhere….But as we’ve also seen from those charts, we’ve got to be humble in the face of nature. And in this country alas as across much of Europe the virus is spreading even faster than the reasonable worst case scenario of our scientific advisers whose models as you’ve just seen now suggest that unless we act we could see deaths in this country running at several thousand a day – a peak of mortality alas far bigger than the one we saw in April…..And let me explain why the overrunning of the NHS would be a medical and moral disaster beyond the raw loss of life. Because the huge exponential growth in the number of patients – by no means all of them elderly, by the way – would mean that doctors and nurses would be forced to choose which patients to treat, who would get oxygen and who wouldn’t, who would live and who would die. And doctors and nurses would be forced to choose between saving Covid patients and non-Covid patients. And the sheer weight of Covid demand would mean depriving tens of thousands, if not hundreds of thousands, if not millions, of non-Covid patients of the care they need. It is crucial to grasp this – that the general threat to public health comes not from focusing too much on Covid, but from not focusing enough, from failing to get it under control.”

The new lockdown, Johnson said, will require that all citizens remain at home from tomorrow until December 2 unless they need to go out for education, medical reasons, in order to care for vulnerable people, exercise and recreation, or because they can’t work from home. Non-essential shops and leisure and entertainment venues will be closed, although click and collect services can continue and essential shops will remain open. But all pubs, bars and restaurants will be closed except for takeaway and delivery services. The plan is to then, after December 2, revert to an improved multi-tier system of regionally-differentiated restrictions, accompanied by a new and improved “test and trace” system with greatly expanded testing.  

Johnson presented his plan to the House of Commons on Monday and it was approved today—despite the opposition of a number of Conservative backbenchers, including, notably, Sir Graham Brady, the chair of the backbenchers’ 1922 Committee, and Sir Iain Duncan Smith, a former leader of the party, who preferred adding another tier to the current three-tier regionally-differentiated restrictions now in effect rather than returning to a full national lockdown. But Sir Keir Starmer, the leader of the Labour Party, had made it clear after the plan was announced, and again today in the debate prior to the vote, that, although he regretted the government’s failure to enact the “circuit-breaker” on transmissions that scientists had proposed in late September, Labour would support the plan, and it was approved by a substantial margin—516 to 39 with 34 abstentions.

There are still a number of European countries with high rates of Covid infection that have not yet done everything they could do to slow the explosion in Covid infections and relieve the mounting pressure on their health systems. Hopefully, the foot-draggers will soon follow the leads of Ireland, the Czech Republic, Spain, Italy, Germany, France, Belgium, Austria, and the UK and move to new lockdowns or other restrictions in order to slow the spread of the virus. National restrictions, even national lockdowns, won’t, of course, stop Covid; the only thing that will do that is a vaccine. But restrictions and lockdowns, when coupled with mask-wearing and social distancing, will at least reduce the rate of increase in infections and, in so doing, relieve the pressure on the national health systems and the intensive care units of their hospitals. And that will save lives.

David R. Cameron is a professor of political science and director of the MacMillan Center’s Program in European Union Studies.